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NHS Dentistry

Volume 485: debated on Tuesday 16 December 2008

5. What his most recent assessment is of levels of access to NHS dental treatment; and if he will make a statement. (243635)

In the 24 months to the end of June 2008, 26.9 million people saw an NHS dentist. Improving access is a top priority and we have increased dental funding to more than £2 billion. In addition, last week we announced that we have set up a review to advise how we can ensure that everyone who wants to see an NHS dentist can do so. The review will be led by Professor Jimmy Steele of Newcastle university.

Over the past two years, my constituents have constantly approached me to say that their dentist has stopped doing NHS work and that, contrary to what the primary care trust website says, they cannot find a dentist in Chesterfield or Staveley who will take new patients. Yesterday, a Chesterfield dentist of 32 years’ experience told me that the current contract is the most bizarre arrangement ever devised by man. Will the Minister finally admit that the Government got the contract completely wrong, that 1.2 million fewer patients are seeing NHS dentists and that the contract needs scrapping and rewriting as quickly as possible?

The British Dental Association is working very positively with us on the contract. The review that we have recently announced is to ask how we can improve access, but there is no question but that access has improved throughout the country.

There is a question whether access has improved throughout the country. I have been telling Ministers for some time that the majority of my constituents, me and my family cannot find an NHS dentist in Leicestershire. That is the fact. Access is not better. The review announced last week is an admission of the failure of the contract. Instead of a review, how about the Government saying what they are going to do about this now to improve access to NHS dentistry.

I suggest that the hon. Gentleman calm down a bit, for the sake of his own health. I am happy to advise him on how to do that. Access throughout the country and the oral health of patients throughout the country have improved. The review is assisting us to improve access. There are open lists in his constituency. That has been stated by the primary care trust.

The Minister will know that there are 24,000 fewer patients registered with NHS dentists in Stockport, compared with 1997. Stockport primary care trust has been offering extra sessions to try to fill the gap, but local dentists prefer to stay private, saying that the fee structure is not sufficient for them to provide a professional service under the NHS. Does she share my concern at the state of NHS dentistry in Stockport and will her review tackle the issue, whereby my patients are denied NHS treatment and, in a recession, are forced either to pay to go private or, worse still, to go without treatment altogether?

The review will be guided by the principles of the NHS next stage review, ensuring that services are responsive to the needs of individual patients, that there is a strong focus on prevention as well as treatment, and that there are continuous improvements in the quality of care, especially in relation to the inequalities at the moment.

The whole House should also recognise the work that dentists have done with the contract and the improvements that have been made, such as the new treatments and the new dentists who are coming out of newly opened dental schools. I look forward to discussing the Health Committee report later this evening.

My good friend the Minister has read the recent Health Committee report on dentistry, so she will be aware that there are parts of the country where very few people have any problems accessing an NHS dentist. That is true in my area, where I serve constituents from south Gloucestershire and Bristol. We found that where commissioning is taken seriously by PCTs and they collaborate with the local dentistry profession, excellent results can be produced. What will she do to ensure that PCTs take this matter seriously and work with their dentists to commission good services?

I thank my hon. Friend. The Health Committee report points out how bad things were in many parts of the country before the contract changed, and how good they are where proper commissioning takes place. That is without question. More work has to be done on commissioning and I know that Professor Steele will be looking at that matter seriously. I welcome the opportunity to share the report with the House soon.

I have a slight interest in this matter, as is well known. The Minister will be aware that there are 13,000 people with oral cancer at any one time in the UK. About 50 per cent. of those people will die, and the mortality rate is getting worse, not better. The key is access—and I believe, as do dentists, that the key to access is the contract. There has been an implementation group running for some time—I do not know its name because it has changed. What suggestions has it made to the Minister to change that contract to make it more desirable for dentists to work for the national health service?

The Health Committee’s suggestions on the hon. Gentleman’s point are taken very seriously by the Department. We want to work with Professor Steele to see how access to oral health can be improved, which the hon. Gentleman rightly raises as a concern; it is a concern to all of us. We want to make the contract work. So many people and PCTs are doing so, and this House should congratulate the dentists who have been working so hard through the new contract.

Availability of NHS dentists in Enfield is not our problem. In fact, there will be an 8 per cent. increase in the coming year, but there is a shortfall in uptake. It is a small shortfall, but none the less it is there. My PCT is going to run a major advertising campaign in the new year to deal with the matter, but constituents tell me that they are not entirely clear what they are entitled to and what it might cost them. Can I suggest that the way in which we communicate with constituents on such matters should be a major part of the review?

I thank my right hon. Friend for her comments on behalf of Enfield. We have to look to PCTs, so many of whom are very imaginative in their advertising and in their use of communication skills, to encourage the best to help the rest. I believe that world-class commissioning will help in that process.

Although health is a devolved matter in Northern Ireland, what steps can the Minister take in conjunction with other Health Ministers right across the UK to ensure that newly qualified dentists take on NHS patients, and that they do so in rural areas and in less populous areas, where the difficulty is more acute?

We are increasingly looking at how we can share best practice with the devolved Parliaments, because we can learn so much from each other. Our new students coming out of dental school are showing a great willingness to work throughout areas, particularly where health inequalities exist, which tends to be more in rural areas because of issues of access.

Telephone services have an effect on access to NHS dentistry and to GPs. What is the NHS doing to cut back on the very regrettable but widespread use of 084 telephone numbers, which cost patients extra money? It is a scandal throughout Government, with thousands of 084 numbers being used, including a lot in the NHS. What are the Government going to do about that?

I thank my hon. Friend for that topical point. We have announced and launched a public consultation today on this issue, which is due to run until 31 March 2009. It will inform the Government’s decisions on the future of such numbers in the NHS. I certainly share my hon. Friend’s concern about those actions, as do the ministerial team.

The British Dental Association will be fascinated by what the Minister said earlier about working with it. This contract was imposed on dentists even though the BDA warned that it would not be any good for British dentistry. Also, a Minister was invited to this year’s BDA national conference, but no Minister turned up, even though one was on the train going to Manchester when I was travelling to speak at the event. I know that we will debate this important issue later, and we have had an excellent report from the Health Committee, but can the Minister explain why she thinks things are going so well when 4,000 patients a day are not able to see an NHS dentist?

On the point about the conference and meetings with the BDA, the chief dental officer and I have regular meetings with the BDA, and the consensus around the table is to work together, which I suppose would be alien to the hon. Gentleman. Working together in partnership with professional organisations that represent health workers right across the board comes naturally to Labour Members, and it will always continue to do so.